We often refer to the stress response as the “Fight or Flight” syndrome, in which we fight the threat or turn and run from it. However, other options exist, including freeze, fright, fawn, or faint.
Essentially, each phase of the stress response represents a defense or survival mechanism.
Signs of catatonia, like withdrawal, immobility, and stupor, may be equivalent to
Summary of emerging themes from subjective descriptions of catatonia | ||
---|---|---|
Thoughts | Feelings | Behaviors |
Fear Yearning (Missing) Confusion/trying to make sense of things wondering about death |
Fear/scared/panicked/anxious Sad and/or anxious Confused Trapped Embarrassed Rejected |
Obeying commands Cooperating with the staff (submission) Withdrawn/keeping to self Sitting still Not talking |
Source: Zingela, Zukiswa et al. “The psychological and subjective experience of catatonia: a qualitative study.” BMC psychology vol. 10,1 173. 15 Jul. 2022, doi:10.1186/s40359-022-00885-7 This article is licensed under a Creative Commons Attribution 4.0 International License.
States of the defense cascade. The diagram depicts the states of arousal, flight or fight, freezing, and tonic/collapsed immobility in terms of patterns of neural activity in the different structures and pathways of the defense cascade network:
I. Arousal, the first step to the activation of the defense cascade, can be viewed as the activation of the hypothalamus pathway. II. Fight or flight involves the activation of the hypothalamus and lateral periaqueductal gray. III. Freezing—flight or fight put on hold—involves activation of the following: hypothalamus pathway; unmyelinated vagal pathway from the dorsal motor nucleus (which opposes the sympathetic activation); lateral periaqueductal gray; and ventrolateral periaqueductal gray (which opposes activation of the lateral periaqueductal gray). IV. Tonic/collapsed immobility involves activation of the unmyelinated vagal pathway from the dorsal motor nucleus and of the ventrolateral periaqueductal gray pathway. In tonic/collapsed immobility, the hypothalamus pathway is not activated. The filled circles depict activated neurons, whereas the open circles depict non-activated neurons. ACTH, adrenocorticotropic hormone; DMN, dorsal motor nucleus of the vagus; Hyp, hypothalamus; LPAG, lateral periaqueductal gray; VLPAG, ventrolateral periaqueductal gray; X, vagus nerve.
Source: Kozlowska, Kasia et al. “Fear and the Defense Cascade: Clinical Implications and Management.” Harvard review of psychiatry vol. 23,4 (2015): 263-87. doi:10.1097/HRP.0000000000000065 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND),
Stress, or our reaction to it, can be paralyzing. However, some simple techniques can help.
Consciously controlling the breath can increase vagal tone, modulate arousal, and improve stress tolerance. Other approaches to managing stress and post-traumatic stress syndrome include:
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Kozlowska, Kasia et al. “Fear and the Defense Cascade: Clinical Implications and Management.” Harvard review of psychiatry vol. 23,4 (2015): 263-87. doi:10.1097/HRP.0000000000000065 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND),
Noordewier, Marret K et al. “Freezing in response to social threat: a replication.” Psychological research vol. 84,7 (2020): 1890-1896. doi:10.1007/s00426-019-01203-4
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